TAMPA — Linda McHale admits she and her husband didn't know much about concussions when two of their sons played organized youth football.
But that was before her husband, former Tampa Bay Buccaneers' player Tom McHale, died in 2008; before doctors learned his brain had sustained concussion-related damage.
"We never had a conversation about concussions," said McHale, adding that her husband never knowingly suffered a single concussion during his career.
The McHales aren't alone. Though a number of highly-publicized hits have thrust concussions to the forefront of conversations among doctors, trainers, officials and coaches, parents have remained largely uninformed on the topic.
A recent national poll found that among parents with children aged 12-17 who play school sports, only 8 percent have read or heard about the risks of repeat concussions, and more than half didn't know if their children's school had a policy about returning to sports after a concussion.
"Parents need to be educated," said McHale, who now speaks on behalf of the Sports Legacy Institute, which works to advance the study and treatment of the effects of brain trauma in athletes. "I'm actually blown away by how much is known about concussions in medical literature, but how little in the public mind."
McHale, doctors and other experts say parents should ask questions of officials and coaches in the leagues in which their children play. They also should know the symptoms of concussions, and when to seek medical help.
Gianluca Del Rossi, an associate professor and head of the University of South Florida's Concussion Center, says parents should ask about:
• The qualifications and experience of the coaches, and about the techniques they teach.
• The age and condition of the equipment. Del Rossi said older helmets can be less effective at cushioning blows. Parents should also make sure their child's equipment fits properly.
• The league's policy on when a player can return to action following a concussion. The American Medical Association now supports a requirement that kids suspected of having a concussion not return to play or practice without a physician's approval.
McHale said parents should also demand that leagues have mandatory training for coaches on concussions.
Once your child is on a team, it's also important for parents to know about concussion symptoms, and what to do if you notice them. A parent's role is crucial, because concussion symptoms may not show up until hours after the hit, said Dr. Jeffrey Kutcher, a neurologist and assistant professor at the University of Michigan.
Symptoms can include: headache, dizziness, personality changes, loss of balance, confusion, problems remembering or concentrating, slurred speech, ringing in the ears or nausea.
Kutcher recommends parents seek medical attention whenever they suspect a concussion. But parents should be aware that their child may try to hide symptoms in an effort to return to action quickly, or that their child simply isn't aware that he or she has had a concussion.
There's also the danger of subconcussive impacts — blows that don't result in concussions. Studies have shown that the cumulative effect of such blows can cause chronic traumatic encephalopathy. That's what doctors found in Tom McHale's brain.
Kutcher says that doesn't mean parents should pull their kids from sports like football.
"If the sport is played the way it's meant to be played, with proper equipment, and injuries properly diagnosed, I really feel the sports are safe," Kutcher said.
As for McHale's boys, they no longer play football. Michael, 12, now plays lacrosse and tennis, and Matthew, 10, plays tennis.
"It took away my husband and their dad," she said. "It just hits a little close to home."